Provider Demographics
NPI:1366855157
Name:MEAD, ERIC J (DDS)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:J
Last Name:MEAD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:827 N CEMETERY RD STE 6
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-9463
Mailing Address - Country:US
Mailing Address - Phone:405-652-1222
Mailing Address - Fax:
Practice Address - Street 1:827 N CEMETERY RD STE 6
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-9463
Practice Address - Country:US
Practice Address - Phone:405-652-1222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-09
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK65961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice